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    What you don't know about choroidal melanoma

    New Orleans—Carol Shields, MD, of Wills Eye Hospital ocular oncology service, shared her advice for what to look out for when it comes to choridal melanoma during the Plenary Session at the American Academy of Optometry meeting in New Orleans.

    More from AAO: Hot topics in dry eye and glaucoma

    Choroidal nevus and melanoma

    Dr.  Shields describes the relationship between choroidal nevus and melanoma as finding a rotten apple.  

    “You go apple picking and among that group of fruit, there’s going to be one that goes bad. And you as eyecare specialists need to know which nevus is going to turn into melanoma,” she says. “Sometimes it’s simple; sometimes it’s very challenging.”

    A recent study found that choroidal nevus occurs in approximately five percent of Caucasians and shows increasingly prevalence with age, says Dr. Shields. She estimates that most eyecare practitioners are seeing at least one patient per day with a choroidal nevus.

    But that study used a database that looked only at the posterior segment of the eye—only within 45 degrees of the macula and the disc. She says that in actuality, up to 20 percent of Caucasians could have a choroidal nevus that you will have to determine whether it could be melanoma.

    Dr. Shields identified a number of features that occur with choroidal nevus. These features can predict growth from nevus into melanoma:

    • Nine percent have a little bit of subretinal fluid

    • Six percent have overlying orange pigment

    • Drusen is present in 60 percent

    • Neovascularization of the choroid rarely occurs

    Next: How to spot the one that will turn into melanoma

    Colleen E. McCarthy
    Colleen McCarthy is a freelance writer based in the Cleveland area and a former editor of Optometry Times. She is a 2010 graduate of the ...

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